Washington Circle Performance Measures and Criminal Justice Outcomes Garnick, D.W. Abstract This is a resubmission of an application building on previous work conducted under an R21 grant from NIAAA (Grant #R21 AA14229) examining the association between Washington Circle (WC) performance measures and outcomes in Oklahoma and exploring the feasibility of conducting similar analyses in other states. In this application, we plan to extend that research by conducting further client-level analyses, focused on WC process measures, for additional client populations (adding measures of continuity of care after detoxification and residential/inpatient services) while controlling for facility level and community level factors. Collaborating with five additional states (MA, CT, NC, WA, and NY) along with Oklahoma's more recent data, the specific aims are to: 1) Evaluate the relationship between client achievement of Washington Circle AOD performance measures and subsequent outcomes regarding criminal justice involvement, employment, and substance use. We will use measures specified by the WC Public Sector Workgroup: initiation and engagement after outpatient treatment, continuity of treatment after detoxification, and continuity of treatment after discharge from residential/inpatient treatment. We will examine their predictive validity with respect to: (1) criminal justice involvement (e.g., any arrest, felony arrest, any conviction, felony conviction, and incarceration, (2) employment at discharge and (3) substance use at discharge. 2) Examine moderating differences - by gender, race/ethnicity and age -- in the relationship between WC AOD performance measures and subsequent outcomes. We will explore whether the predictive validity of the WC performance measures differ by client subgroups, including interactions among the subgroups, e.g., younger Black males. 3) Examine whether prior criminal justice involvement moderates the relationship between WC AOD performance measures and subsequent criminal justice outcomes. Establishing the predictive validity of the WC process measures is a key step in ongoing assessments of their suitability and acceptability as tools for measuring quality. In planning quality improvement activities, it is vitally important for states and providers to understand whether initiation, engagement and continuity of treatment are linked to key outcomes. PUBLIC HEALTH RELEVANCE: Project Relevance. Establishing the predictive validity of the WC process measures is a key step in ongoing assessments of their suitability and acceptability as tools for measuring quality. In planning quality improvement activities, it is vitally important for states and providers to understand whether initiation, engagement and continuity of treatment are linked to key outcomes.